| NPI | 1003175662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXIS WIESENTHAL President 210-857-3767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX N1219) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N1219) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2012-05-16 |